Innovative technology helps protect brain after cardiac arrest

January 29, 2007
When Judy Peschard’s husband Joel had a heart attack last June, she had no way of knowing if he would survive, and if he did, whether he would have permanent brain damage. Joel had no pulse for 30 minutes. Paramedics were able to get his heart started, but he remained unresponsive.

“It scared me,” she said. “I didn’t know how far he would come back.”

On his arrival at New Hanover Regional Medical Center, Joel Peschard was fortunate to receive a relatively new technology. Doctors induced mild hypothermia with equipment purchased by the hospital just a few months earlier.

The Arctic Sun system is a non-invasive way to lower the body’s temperature. The system was recognized as a breakthrough medical technology and named a runner up for the Wall Street Journal’s 2006 Technology Innovation Award. New Hanover Regional is the first hospital in North Carolina to own it.

Thaddeus Dunn, MD, critical care specialist at NHRMC, helped make the case to bring the technology to Wilmington. “Research shows that when an individual has an out-of-hospital cardiac arrest and is resuscitated, but comatose, if you can cool them for 24 hours, they have a better chance of waking up with good brain function,” he said.

Cooling slows down the body’s metabolism, giving the brain a chance to recover from the trauma of a heart attack and the loss of blood flow. Without it, the body works harder as the organs compete for oxygenated blood. The resulting fever and swelling in the brain can cause severe brain damage.

“A lot of patients who survive cardiac arrest have brain injury,” said Carolyn Brown, Clinical Education Specialist with the NHRMC Heart Center. “So the heart is fixed, but the brain injury is devastating. They could need nursing care the rest of their lives.”

Finding a way to protect brain function after someone has a heart attack outside the hospital has become a higher priority in recent years as more people are able to survive the initial attack.

“Ten years ago, it wouldn’t be a big issue, because it was uncommon for them to come in resuscitated,” said Dr. Dunn. “Now that automatic external defibrillators are small, portable, and easy to use, more people are getting their hearts shocked back into rhythm. The blood flow gets restored, but we need to allow the brain to come back, too.”

Judy Peschard waited for three days to see how her husband would wake up. He was sedated to keep his body from shivering.

“It was unnerving,” she said. “It was hard to sit with him because his hands were so cold. We really wanted to climb in bed with him to warm him up.”

When doctors felt he was ready, they removed Peschard from the Arctic Sun and took him off his medications. “He woke up immediately,” his wife said.

Although the process of recovery was gradual, Peschard left the rehabilitation hospital within a couple of weeks, able to walk and take care of himself. He went back to work a few months later.

“It’s amazing,” said Dr. Dunn. “The numbers are significantly improved. We don’t save them to send them to nursing homes. We are saving them so they can go back to normal, or near normal, lives.”